REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
June 23, 2026
FROM
JOSHUA DUGAS, Acting Director, Department of Behavioral Health
SUBJECT
Title
Contract with Loma Linda University Children’s Hospital for Pre-Forensic Examination Counseling Services
End
RECOMMENDATION(S)
Recommendation
Approve Contract with Loma Linda University Children’s Hospital, including a non-standard term, for the provision of pre-forensic examination counseling services, in an amount not to exceed $750,000, for the period of July 1, 2026 through June 30, 2029.
(Presenter: Joshua Dugas, Acting Director, 252-5142)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
Approval of this item will not impact Discretionary General Funding (Net County Cost). The recommended contract amount of $750,000 for pre-forensic examination counseling services will be funded by Behavioral Health Services Act funds. Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2026-27 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
DBH is responsible for providing mental health and substance use disorder (SUD) services to county residents experiencing severe mental illness and/or SUD. The Children’s Assessment Center (CAC) operates through a collaborative partnership between Loma Linda University Children’s Hospital (LLUCH) and the County. Through this partnership, DBH facilitates the delivery of pre-forensic counseling services to children, youth, and families affected by allegations of sexual or physical abuse. These services, provided by LLUCH physicians, nurse practitioners, and registered nurses, are designed to minimize trauma and psychological distress throughout the investigative process. The partnership also facilitates coordination among the various agencies involved in suspected child abuse investigations.
On September 29, 1986 (Item No. 62), the Board of Supervisors approved an agreement establishing a public-private partnership between the County and LLUCH to develop and operate a centralized, multi-disciplinary interview center. Since 1994, the CAC has operated as a one-stop center where child victims of sexual and physical abuse receive forensic interviews, counseling, and evidentiary medical exams. The CAC’s mission is to minimize trauma to children and youth during abuse investigations and for child witnesses of violent crimes. LLUCH indicated that they provide services to at least 5,000 children and youth per year.
In 2023, LLUCH added the Resiliency Institute for Childhood Adversity (RICA) Clinic, a secondary location where forensic examinations are performed. Under the proposed contract, funding will continue to support LLUCH’s physicians, nurse practitioners, and registered nurses in providing counseling services prior to conducting forensic medical examinations and interviews for trauma-exposed children and youth. As a result of the additional RICA site, DBH anticipates more youth will be served, and the cost per client will increase due to staff rate increases among LLUCH medical professionals.
In 2024-25, LLUCH achieved the following outcomes:
• 763 unduplicated clients provided pre-forensic counseling
• At an average cost of $113 per client
Upon approval of the recommended Contract, DBH anticipates LLUCH will:
• Provide approximately 1,381 unduplicated clients pre-forensic counseling per year
• At an average cost of $181 per client per year
The Contract with LLUCH deviates from the standard County contract terms as follows:
1. The County is required to indemnify and hold LLUCH and its officers, employees, and agents harmless from and against all claims and costs (including reasonable attorneys’ fees) resulting from the performance of the Contract, but only in proportion to and to the extent that such claims and costs are caused by, or result from, the County’s negligent acts or omissions.
• Issue: The County standard contract does not include any indemnification or defense by the County of a contractor.
• Potential Impact: By agreeing to indemnify LLUCH, the County could be contractually waiving the protection of sovereign immunity. Claims that may otherwise be barred against the County, time-limited, or expense-limited could be brought against LLUCH without such limitations and the County could be responsible to defend and reimburse LLUCH for costs, expenses, and damages, which could exceed the total Contract amount.
DBH recommends the approval of the Contract, including the non-standard term, to ensure the continued provision of pre-forensic examination counseling services. These services provide critical support and resources before, during, and after the forensic exam to reduce trauma and psychological distress for children, youth, and families impacted by allegations of abuse.
Performance measures for this Pre-Forensic Examination Counseling Services contract focuses on tracking service quality, timeliness, accessibility, and outcomes to ensure the provider meets established standards. The contractor is required to submit regular reporting such as monthly service logs, outcome data, fiscal reports, and compliance documentation, which allows the department to monitor progress and identify trends or concerns. Accountability mechanisms, including performance audits, contract monitoring meetings, site visits, and corrective action plans, help ensure that services are delivered as intended and align with program goals. Together, these structures promote transparency, support continuous improvement, and ensure that community members receive high-quality, effective behavioral health services.
PROCUREMENT
Purchasing supports the non-competitive procurement of specialized forensic interviewing and trauma-informed support services for children and youth impacted by abuse or violent crime based on LLUCH’s unique qualifications and specialized expertise.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health (Marianna Martinez, Administrative Supervisor II, 383-3940) on May 13, 2026; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on May 15, 2026; Risk Management (Stephanie Pacheco, Staff Analyst II, 386-9039) on May 18, 2026; Purchasing Department (Jessica Barajas, Supervising Buyer, 387-2060) on May 26, 2026; and County Finance and Administration (Iliana Rodriguez, Administrative Analyst, 386-8392) on May 27, 2026.